The presence of channelopathies in drowning and near-drowning-events in pediatric population

Abstract

INTRODUCTION: Drowning incidents are the cause of the 52’7 % of all the death in people under 15 years (372.000 deaths per year). For each child dead by a drowning episode, it is estimated than another four children experience a serious non-fatal drowning event. In comparison with other activities, swimming is now a well-stablished trigger of arrhythmia in people who have LQTS or CPVT. HYPOTHESIS AND OBJECTIVES: The aim of this retrospective descriptive study is to discover if there are underlying cardiac channelopathies in drowning and near-drowning incidents that happened between 1997 and 2017 in patients registered in Emergencies and Intensive Care Units of SJD Hospital. METHODS: A registry of 155 patients listed for having suffered a drowning or near-drowning event was described and analysed, attending to epidemiological data, clinical aspects, familiar background, all diagnostic tools used and their results. RESULTS: ECG was performed in 26,5% patients of those 155 patients registered, five of them were positive for LQTS, what supposes a 12,2% of these 41 performed ECG. Five patients did have a genetic test performed, all of them resulted positive. CONCLUSIONS: Because ECGs and genetic tests are not performed as part of the drowning and near-drowning events protocol, there is a potential underestimation in the diagnosis of these channelopathies in cases of drowning and near-drowning events. ECGs and genetic tests are both fundamental in the diagnosis of both LQTS and CPVT diseases. Due to this fact, it is essential to proceed to do both of them when a patient has suffered from a drowning or near-drowning event, apart from a stress test to unmask a possible underlying CPVT once patients have recovered from the incident